radiation for positive margins

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6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 8/26/2009 10:49 AM (GMT -6)   
got my first dose of  radiation to day for the positive margin
i will be getting 33 sessions - 66 Grays
Age 61 at DX
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
26/1/2009  < 0.1
20/4/2009 < 0.1
20/7/2009 < 0.1
 
 







Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/26/2009 11:13 AM (GMT -6)   
Hi 6071,
I am interested in more of your story. It's been 6 months and you have had a clean slate with the PSA's. I am a proponant of adjuvant radiation in cases like yours but there are some differences of what we call standard here in the States. 33 treatments of which kind of radiation ~ EBRT or IMRT? Is this standard protocol in Ireland?

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/26/2009 11:55 AM (GMT -6)   
With all your post surgery psa's of zero, why now? what made the difference to go ahead and start treatments?

david in sc
 Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, 8/14 met with Rad Oncl, 8/18 - laser scope surgery to clear blockage, now on Cath #7, 8/26 - cath removed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 8/26/2009 2:54 PM (GMT -6)   
TC-LasVegas
i think i am getting IMRT radiation will ask tomorrow
Purgatory
when i had rp surgery my surgeon said i was to get it.
over hear we have a waiting list so it could be long wait if i have a rise in psa
we are not as fast over hear with treatment as you are in the usa
if you have the cash it is fast
surgery is done in 1 hospital radiation in an another hospital
had a ct scan in june and a ultra sensitive psa test i still did not get the psa results i will get it next week sometime
did not meet one doctor to day just the radiation team
and i had to drink loads of water before the radiation treatment plus i have to drink 2 liters a day
thanks
Age 61 at DX
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
26/1/2009  < 0.1
20/4/2009 < 0.1
20/7/2009 < 0.1
 
 







Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/26/2009 4:00 PM (GMT -6)   
6071, that makes perfect sense, didnt mean to sound crititcal, wasn't my intent.

surgery is one place here: hospital, and radiation is in another: radiation treatment center

david in sc
 Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, 8/14 met with Rad Oncl, 8/18 - laser scope surgery to clear blockage, now on Cath #7, 8/26 - cath removed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 8/26/2009 4:08 PM (GMT -6)   
I may be on the same track in terms of time. If my PSA's stay at zero, I am not planning on adjuvant radiation until my incontinence and ED are stabilized (hopefully). Even then I am not sure if I will do it until my PSA starts to rise.

Statiscally it doesn't appear to be a lot of difference between adjuvant and salvage, if salvage is begun early enough, and from a morbidity viewpoint, there is little difference.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 8/26/2009 9:23 PM (GMT -6)   
I am two treatments in. I am getting 40 treatments for a total of 72 Grays to prostate bed and 45 Grays to pelvis. Plus HT. Mine is salvage, not adjuvant, but as Goodlife said, there is not a lot of difference, statistically speaking. I was hoping I would not need it...

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug


zampilot
Regular Member


Date Joined Aug 2009
Total Posts : 152
   Posted 8/28/2009 6:10 AM (GMT -6)   
6071, our history is quite similar but I'm 53. I'm getting my 12th rad today, 1/3 done with it. I had one margin, called a 'close' by one Doc, a 'positive' by another. It was "into the orange peel but not out of it" (meaning the prostate). My Rad Oncologist cited a european study, long term, which found a 40% chance of recurrence vs < 5% with radiation if any of the following were found in the surgery path report or first post surgery PSA test: involvment of the seminal vesicles, lymph nodes, high PSA or ....a positive margin.
I'm taking the rad even though there's not much chance one cell escaped the scalpel, but if one cell did escape, that's it, no cure.

Post Edited (zampilot) : 8/28/2009 6:34:16 AM (GMT-6)


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 8/28/2009 1:57 PM (GMT -6)   

thanks

zampilot


Age 61 at DX
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
26/1/2009  < 0.1
20/4/2009 < 0.1
11/6/2009 ultra sensitive psa 0.07
20/7/2009 < 0.1
26/8/09 Starting IMRT
 
 






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